Amazon Launches AWS HealthScribe – A HIPAA-Eligible AI-Powered Transcription Tool

Posted by Steve Alder

Generative artificial intelligence chatbots such as OpenAI’s ChatGPT are attractive tools for clinicians as they can be used to automate repetitive administrative tasks such as producing medical notes for electronic medical records, saving considerable time. The problem with many of these tools is they cannot be used in connection with protected health information without violating the Health Insurance Portability and Accountability Act (HIPAA) Rules. At present, OpenAI will not sign a business associate agreement with healthcare providers, so any protected health information processed by ChatGPT would be classed as an impermissible disclosure.

Amazon has recognized the need for an AI-based digital stenography tool for physicians and has recently launched its own generative AI service focused specifically on healthcare providers – AWS HealthScribe. According to Amazon, its new AI-based service will reduce the time doctors have to spend on clinical documentation. The tool can analyze and transcribe conversations between doctors and patients and provide a summary of the key points for entry into a patient’s medical record. “With AWS HealthScribe, healthcare software providers can use a single API to automatically create robust transcripts, extract key details (e.g., medical terms and medications), and create summaries from doctor-patient discussions that can then be entered into an electronic health record (EHR) system,” said Amazon in a press release announcing the new tool, which is charged per second of audio processed each month. Crucially, Amazon’s offering is HIPAA-eligible. Amazon will sign a business associate agreement with HIPAA-regulated entities covering the new tool.

According to Amazon, users will have full control over their data, including storage locations for transcriptions and preliminary clinical notes, and the tool can be integrated into healthcare providers’ own clinical applications, rather than having to use a standalone app. Amazon has also confirmed that AWS will not use any inputs or outputs generated through AWS HealthScribe to train AWS HealthScribe. Initially, the tool is being previewed for general medicine and orthopedics; however, AWS may expand to other specialties based on client feedback. The tool is attracting considerable interest, with 3M Health Information Systems, Babylon, and ScribeEMR among the companies planning to integrate the tool into their own systems.

While the new tool has the potential to save physicians countless hours of documentation time, the usefulness of the tool will depend on accuracy. Amazon is not the only tech firm to provide a generative AI-based notetaking product that can be used by HIPAA-regulated entities. Like Microsoft’s Nuance and Google’s Suki, Amazon has not published data on the accuracy of the tool, although the generated summaries include highlighted text from the transcript to allow physicians to review the generated content prior to authorizing entry into EHRs.

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AHA, AMA, BCBSA Urge CMS Not to Adopt Proposed Standards for Healthcare Attachments

Posted by Steve Alder

The HHS’ Centers for Medicare and Medicaid Services (CMS) is being urged not to implement the proposed standards for prior authorization attachments, as detailed in its December 2022 Notice of Proposed Rulemaking (NPR). In a letter to CMS Administrator, Chiquita Brooks-LaSure, the American Hospital Association (AHA), American Medical Association (AMA), and Blue Cross Blue Shield Association (BCBSA) applauded the CMS for its focus on reforming prior authorization to ensure timely access to care for patients while minimizing manual paperwork for all healthcare stakeholders, but expressed their concern that the proposed changes would likely cause widespread industry confusion, be enormously expensive, and would create the same costly burdens that the proposed standards seek to alleviate.

“First, major efforts are underway to automate PA-related data exchange leveraging Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) implementation guides,” explained the trade groups in the letter. “Secondly, and even more significantly, the Advancing Interoperability and Improving Prior Authorization NPRM (CMS-0057-P) would require federally regulated health plans to offer HL7 FHIR-based application programming interfaces to support electronic PA information exchange. In contrast, the attachments NPRM would require a combination of both X12 and HL7 standards and apply to all health plans under the Health Insurance Portability and Accountability Act (HIPAA) regulatory pathway.”

The NPRMs would create conflicting provisions and would establish two different sets of standards and workflows to complete the prior authorization process and federally regulated health plans would be required to crosswalk the two standards for no discernible benefit. That would directly counter the foundational principles of the original HIPAA administrative simplification regulations, which require the adoption of uniform electronic standards to support communication between providers and all health plans. As such, the AHA, AMA, and BCBSA strongly advise against the adoption of the standards for prior authorization attachments.

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